Long-Term Outcomes of Heart Transplantation Using Hepatitis C-Positive Donors.

Authors

You-Min Lu, Po-Sung Chen, Yi-Chan Lee, Sheng-Ming Ling, Chih-Ying Chang, Chung-Yi Chang, Jeng Wei

Published in

Transplantation proceedings. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

The global shortage of donor organs has prompted the utilization of extended criteria donors, including those infected with hepatitis C virus (HCV). While direct-acting antivirals (DAAs) have made this strategy feasible, data regarding long-term outcomes in the Asian population remain limited. We aimed to evaluate the long-term survival outcomes of heart transplantation (HT) using HCV-positive donors in a single-center Asian cohort.
This retrospective study analyzed 451 adult HT recipients at a single center in Taiwan between July 1, 1988, and June 30, 2024. Patients were stratified into HCV-positive donor (n = 20) and HCV-negative donor (n = 431) groups. Propensity score overlap weighting (OW) was employed to balance baseline characteristics. The primary endpoint was long-term all-cause mortality.
The median follow-up duration was 10.5 years. All recipients of HCV-positive hearts who developed viremia achieved a sustained virologic response (SVR12) with DAA therapy, resulting in a final cure rate of 100%. Kaplan-Meier analysis revealed no significant difference in long-term survival between the 2 groups (log-rank P = .136). In the overlap-weighted Cox proportional hazards model, donor HCV status was not an independent predictor of 10-year mortality (adjusted hazard ratio [HR] 1.88; 95% confidence interval [CI] 0.50-7.05; P = .350).
HT using HCV-positive donors is a viable strategy in the Asian population, yielding long-term survival comparable to that of HCV-negative donors. With the availability of effective DAA therapy, this approach can be successfully implemented to expand the donor pool without compromising recipient outcomes.

PMID:
42608263
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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